The management of severe aortoiliac occlusive disease: Endovascular therapy rivals open reconstruction

Abstract

R/PTAS is a suitable, less invasive alternative to ABF for the treatment of severe AIOD. Repair of the concomitant femoral occlusive disease is often needed regardless of open or endovascular treatment. Infrainguinal disease negatively affects the durability of the procedure and patient survival.

SCAI expert consensus statement for aorto‐iliac arterial intervention appropriate use

“…The stent data for more complex lesions such as TASC C/D and other CTO lesions are also encouraging (Table II) [14,18,19,22,24]. According to two recent meta-analyses [18,19], immediate technical success rates for aorto-iliac intervention exceed 90%, with 4-5 year primary patency rates of 60-86%, secondary patency rates of 80-98%, and limb salvage rates of 98%.…”

“…In the case of "kissing stents," this creates a new bifurcation of the aorta. More than one access site (a second site could be femoral or brachial/ radial) may be required to approach chronic total occlusions (CTO), in order to facilitate both antegrade and retrograde crossing and also for better visualization of the extent of occlusion [13,14]. For example, in long CIA to distal EIA CTOs, often bilateral access is required.…”

“…The technique or device used depends both on lesion characteristics and physician experience. Using multiple techniques, the overall success rate of crossing even complex (TASC C and D) lesions is expected to be 85-95% for experienced operators [14,18,19].…”

“…One option is to perform a hybrid procedure with open femoral endarterectomy (with or without profundoplasty) followed by iliac stenting [6,14,34]. This hybrid approach limits the open surgery to the groin and avoids complications associated with aortic cross clamping and laparotomy [14,24].…”

Surgical Treatment of Atherosclerotic Lesion of Iliac Arteries by Method of Loop Endarterectomy

“…Сердечно-сосудистые заболевания / Cardiovascular medicine В настоящее время во всем мире для лечения ате-росклеротических поражений подвздошных арте-рий все шире применяются эндоваскулярные вме-шательства, включающие баллонную дилятацию и стентирование [1,2,3,4,5,6,7,8,9,10,11,12]. Однако наряду с ними существует другой малотравматич-ный способ лечения, приобретающий все большую популярность -эндартерэктомия при помощи раз-личных петель и колец (ПЭАЭ).…”